The head of the NHS in Scotland is determined that it implements as "quickly as possible" the 75 recommendations for change made by an inquiry into a deadly outbreak of Clostridium difficile.

Paul Gray, chief executive of NHS Scotland, said he was "clear that we must take the actions necessary to ensure that patients everywhere receive the care they expect and deserve".

He spoke out as he published his annual report examining how the health service performed in 2013-14.

Mr Gray insisted that the NHS in Scotland had "come a long way this year", with improvements in hospital safety, the number of cancer patients who are diagnosed early and improvements in accident-and-emergency waiting times.

But he stressed: "There is no room for complacency. I know that there are demands facing the NHS now and that these will grow over the next few years."

Mr Gray said the increasingly elderly population - and their more complex medical demands - meant the NHS needed to change the way care is provided to people.

While he said there had been "real progress" in Scotland's health overall, he added that "entrenched health inequalities remain and addressing these is a real priority for me".

Action is also being taken to reduce bed-blocking, a problem which means patients having to remain in hospital when they are fit to leave as the community support they require is not available.

"Reducing the number of people delayed in hospital is vitally important for patients, carers and families. We are tackling that now," Mr Gray said.

After a public inquiry found "serious personal and systemic failures'' had contributed to the C.diff outbreak at the Vale of Leven Hospital in West Dunbartonshire, Mr Gray pledged action would be taken.

The inquiry discovered the bug was a factor in the death of 34 out of 143 patients who tested positive for the infection at the hospital during the period January 1 2007 to December 31 2008 - although inquiry chairman Lord MacLean said the true figure could be higher still as medical records were not available for all the patients who died.

Health Secretary Shona Robison has already committed to take all the steps needed to ensure that such a tragedy does not happen again.

Mr Gray said: "I am also determined to ensure that the recommendations from the Vale of Leven inquiry are implemented as quickly as possible.

"The families affected deserved, and received, a full and unqualified apology for what they had suffered. I repeat that here and pay tribute to the dignity that they have shown."

The inquiry report was "rightly critical of the care provided", Mr Gray said, as he vowed to "redouble our efforts to ensure people receive the care they expect and deserve".

The NHS chief executive added: "The report itself had wide-reaching implications for the whole of NHS Scotland.

"While we have made very significant progress on patient safety since the issues covered by the report, I am clear that we must take the actions necessary to ensure that patients everywhere receive the care they expect and deserve.

"There is no room for complacency. I know that there are demands facing the NHS now and that these will grow over the next few years.

"More people than ever are living longer, with more complex conditions, and while increased life expectancy is very welcome, it means the way we deliver care has to change.

"That is why we are implementing the integration of health and social care with real determination.

"We also need to increase our focus on improving the health of the population.

"There has been real progress over the last decade but entrenched health inequalities remain, and addressing these is a real priority for me."

He concluded: "While undoubtedly challenges remain, I have confidence in the people working throughout NHS Scotland and I know they are committed to delivering the best possible care for patients.

"As my report shows, there is much to be proud of in our NHS and it is this wealth of talent we will build on as we seek to make NHS Scotland one of the best healthcare systems in the world."

ends